Lec.4 Suture Flashcards
What is the purpose of using toothed or untoothed forceps during suture placement?
To stabilize the tissue and allow for proper suture placement.
What is the risk associated with grasping the needle near the eye or swage?
The risk is that the needle is more likely to bend or break unless delicate tissue is being sutured.
What are the advantages and disadvantages of holding the needle near different parts?
Holding the needle near the pointed end allows for the greatest driving force when suturing tough tissue but makes extraction difficult. Grasping near the eye or swage allows maximum needle length for suturing and reduces needle slippage but increases the risk of bending or breaking. Grasping near the center allows greater force and less risk of breakage.
Why should needles generally be placed perpendicular to the needle holder?
Placing needles perpendicular to the needle holder allows for the greatest maneuverability.
What is the importance of grasping and stabilizing the needle before removing the needle holder?
Grasping and stabilizing the needle before removing the needle holder is important to decrease the risk of losing the needle in the dermis or subcutaneous fat, especially when small needles are used.
Why are forceps necessary during suturing?
Forceps are necessary for grasping the needle as it exits the tissue after a pass, which helps stabilize the needle and decreases the risk of losing it in the dermis or subcutaneous fat.
What type of needle is recommended for the Ford interlocking suture to expedite the suturing process?
A large serpentine needle is recommended for the Ford interlocking suture to expedite the suturing process.
What is the purpose of using a Ford interlocking suture for skin closure?
The Ford interlocking suture is used for skin closure to provide a secure and efficient method of suturing.
What angle should the needle penetrate the skin to minimize the size of the entry wound?
The needle should penetrate the skin at a 90° angle.
Why is it important for the needle to penetrate the skin at a 90° angle?
It minimizes the size of the entry wound and helps to restore the anatomy correctly.
What is the principle of equal bites in suturing?
The ‘bite’ taken on one side of the wound must be equal to the bite taken on the second side.
What is the general guideline for the distance sutures should enter and exit from the wound margin?
In general, sutures should enter and exit at an equal distance from the wound margin.
How far from the wound edge should the needle be inserted when suturing?
The needle should be inserted 1 - 3 mm from the wound edge, depending on thickness.
What is the typical spacing between sutures in relation to the needle entry?
Spacing between sutures is typically equal to the distance from needle entry to wound margin.
What is the primary use of the square knot in suturing?
To start and finish all suture patterns, whether continuous or interrupted.
What is the basic component that all suture patterns start with?
The square knot.
What is a surgeon’s knot and when is it used?
A surgeon’s knot is produced by passing one strand through the loop twice on the first throw of a square knot. It is occasionally used for closure of tissues where tension on the tissues makes it difficult to apply a regular square knot.
What is the correct method for pulling out the suture strand?
Gently pull the suture strand out through the side opposite the knot with the forceps, ensuring not to pull any portion that has been outside the skin back through the skin.
How should the suture be cut during the removal process?
Pick up one end of the suture with thumb forceps or thumb and index finger, and cut as close to the skin as possible where the suture enters the skin.
What is the first step in the suture removal process?
Cleanse the area with an antiseptic, using hydrogen peroxide to remove dried serum around the sutures.
How are suture patterns typically categorized?
Suture patterns are typically categorized as continuous or interrupted, inverting, appositional, or everting, and tension suture.
What factors influence the choice of suture technique?
The choice of suture technique depends on the type and anatomic location of the wound, the thickness of the tissue, and the degree of tension.
What is a disadvantage of continuous suture patterns?
Continuous suture patterns provide less precise control of wound approximation and tension, and failure of a knot may lead to disruption of the suture line.
What is a disadvantage of interrupted suture patterns?
Interrupted suture patterns require more time to tie individual knots, have poor suture economy, and increase the amount of foreign material in the wound.
What is an advantage of interrupted suture patterns?
Interrupted suture patterns allow adjustment of tension throughout the suture line, and the failure of one knot is often inconsequential.
What is an advantage of continuous suture patterns?
Continuous suture patterns are faster and involve less foreign material in the wound.
What is the technique for placing a simple interrupted suture?
The needle is inserted 1 - 3 mm into one side, advanced to the bottom of the wound, then traversed into the other side, exiting on the opposite side of the wound.
What are the advantages of using interrupted sutures?
Interrupted sutures are easy to place, have greater tensile strength, and have less potential for causing wound edema and impaired local circulation.
What is the purpose of using small bites in suturing?
Small bites can be used to precisely coapt wound edges.
What is the importance of proper tension in suturing?
Proper tension is important to ensure precise wound approximation while preventing tissue strangulation.
What types of tissues can be sutured?
Sutures can be used on skin, subcutaneous tissue, vessels, nerves, gastrointestinal, respiratory, and urinary tracts.
